Protect your skin from the ravages of the sun

Vermont ranks high in skin cancer diagnoses

By Phyl Newbeck

Observer correspondent

Some of us did some foolish things as children and young adults. Maybe we drove too fast, smoked cigarettes, drank too much, or maybe we used to bask in the warm, reflecting rays of the sun. It turns out that last habit may prove to have been just as dangerous as the other three.

Vermont may not be the sunniest state, but that doesn’t mean Vermonters shouldn’t worry about skin cancer. In fact, according to the Environmental Protection Agency, Vermont had the highest rate of new melanoma diagnoses in the U.S. between 2001 and 2005—63 percent higher than the national average. In 2008, 180 Vermonters were diagnosed with melanoma, the most dangerous form of skin cancer. Bennington County had the highest rate of melanoma of any county in the country—179 percent above the national average. Approximately 20 Vermonters die annually from skin cancer, and the state had the 13th highest death rate nationally from 2001-5, 11 percent higher than the U.S. figure.

The Vermont Cancer Registry reports that although melanoma affects all age groups, it is one of the most common cancers in the age 20-49 age range. The good news is roughly 85 percent of melanomas in Vermont are caught when the cancer is still localized.

The likelihood of developing skin cancer is based on a combination of environment, genetics and lifestyle choices. People with fair skin, red or blond hair and blue eyes are at a greater risk, as are those who have had at least one blistering sunburn as a child or teenager. Skin cancer can be treated by surgery, chemotherapy, radiation therapy or biologic therapy.

To avoid skin cancer, it is best to stay out of the midday sun, cover exposed skin with sunscreen with an SPF rating of 30 or higher and, if possible, wear long sleeves, long pants and a wide-brimmed hat. The Vermont Department of Health cautions that the UV rays can penetrate light clothing, windshields and windows.

According to Dr. Steven Partilo of Four Seasons Dermatology in Colchester, there are three types of skin cancer: squamous cell; basal cell; and melanoma, the latter being the most dangerous. He recommends that people use sunscreen lotions with zinc or titanium as their active ingredient for maximum protection. He also suggests that people who spend time outdoors should check their skin on a monthly basis, particularly if they have a lot of moles. In doing self-examinations, patients should use the acronym ABCDE. A stands for asymmetry, B for irregular border, C for color (look for moles that are dark or varied), D for diameter (larger than ¼ inch) and E for evolving or changing over time. Those with risk factors such as a family history of melanoma or a history of sunburns should also visit a dermatologist annually. Partilo said most skin cancers are found on the head and neck so using sunscreen on those areas and wearing a hat with a brim is advised.

Beyond cancer, there are other types of damage the sun can do to your skin. Partilo said most sunburns should simply be treated with topical measures like moisturizing creams including some which have small amounts of cortisone. For very severe sunburns, oral steroids might be prescribed. Excessive time in the sun can also lead to what are commonly called age spots—photo aging is the term used by Partilo. In addition to spots, excessive sun use can change the elasticity of the skin. Spots can be treated by bleaching creams or laser treatment and certain types of spots can be frozen using a process called cryotherapy.

Partilo stressed that tanning beds are not a safe alternative to sitting out in the sun. In fact, the recent increase in melanomas might be traced to use of those beds, which is why Vermont became the second state in the nation to prohibit minors from using tanning salons. Partilo said other states are now following our lead.

Partilo said the reason Vermont ranks among the highest states for melanoma is because the state has a very small minority population. While he hastened to add that people of all complexions can develop skin cancer, the fact remains that fair skin is considered a risk factor. Partilo believes that even those with multiple risk factors can protect themselves without completely shunning the outdoors. “You don’t have to change your lifestyle,” he said “but use common sense.”